Case Submission
Practice Name
E-mail
example@example.com
Phone Number
Tooth Number
Shade
Restoration Type
Please Select
Cement type with no occlusal hole
Screwmentable/ SCRP with occlusal hole
UCLA type with Titanium
One body restoration with Ti base
Zirconia abutment with Ti base
Impression Type
Please Select
PVS impression (Triple Tray)
PVS impression (quadrant/ full tray)
Intraoral scan
Prescription(Please include the implant platform and size)
Is this BSB/Lab Pronto case?
Please Select
Yes
No
File Upload (Please compress all the stl/obj/ply files together into one zip file and upload the zip file)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Patient Name
First Name
Last Name
Should be Empty: